Flashcards in Fiser Liver Deck (68)
What is the #1 hepatic artery variant?
right hepatic artery off of the SMA (courses behind pancreas, posterolateral to CBD)
what does the falciform ligament contain?
remnant of umbilical vein
what separates the right and left lobe of the liver?
portal fissure or cantlie's line: line drawn from the middle of the gallbladder fossa to IVC
what are liver macrophages called?
whats the portal triad?
CBD (lateral), portal vein (posterior), proper hepatic aa (medial)
what are the boundaries of the Foramen of Winslow?
Anterior: portal triad
what joins together to make the portal vein?
SMV and splenic vein
most primary and secondary liver tumors are supplied by what artery?
what segments of the liver do the left, right and middle hepatic arteries supply?
Left: II, III, IVa (superior)
Middle: V, IVb (inferior)
Right: VI, VII, VIII
*caudate lobe has separate arteries and veins*
what is the usual energy source for the liver?
which clotting factors are not made in the liver?
von willebrand factor and factor VIII (endothelium)
what is the only water soluble vitamin stored in the liver?
what percentage of liver can be resected?
what are the steps from hemoglobin to bilirubin?
hemoglobin -> heme -> biliverdin -> bilirubin
what are the primary bile acids? secondary?
primary: cholic, chenodeoxycholic
secondary: deoxycholic and lithocholic
what is the main biliary phospholipid and whats the function?
lecithin: emulsifies fats and solubizes cholesterol
where is jaundice first evident?
under the tongue
what is Gilbert's disease
abnormal biliary conjugation, mild defect in glucuronyl transferase
what is crigler-najjar syndrome?
inability to conjugate bilirubin, severe deficiency in glucuronyl transferase, high unconjugated bilirubin, life threatening
what is physiologic jaundice of the newborn?
immature glucuronyl transferase, high unconjugated bilirubin
what is rotor's syndrome?
deficiency in storage ability of conjugated bilirubin, high conjugated bili
what is dubin johnson's syndrome?
deficiency in secretion ability, high conjugated bilirubin
fulminant hepatic failure can w which strands of viral hepatitis?
B,D, E (RARELY A and C)
most common viral hepatitis strand worldwide
most common viral hepatitis strand leading to live txp
what is the drug used to cure hep c
sovaldi: inhibits hep c protein
when do you see hepatitis E?
fulminant hepatic failure in pregnancy, most often in 3rd trimester
what viral hepatitis strand has the highest overall mortality?
hep B + D (D is cofactor and worsens prognosis)
what is the best indicator of synthetic function in pt w cirrhosis?
prothrombin time (PT)